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Benefit of E-Cigarettes for Quitting Smoking Unclear

THURSDAY, Nov. 12, 2020 -- It is unclear whether the addition of nicotine electronic cigarettes to counseling leads to higher rates of smoking cessation than counseling alone among adults motivated to quit, according to the results of a study published in the Nov. 10 issue of the Journal of the American Medical Association.

Mark J. Eisenberg, M.D., from McGill University in Montreal, and colleagues randomly assigned adults motivated to quit smoking from November 2016 to September 2019 at 17 Canadian sites to nicotine e-cigarettes (128 participants), non-nicotine e-cigarettes (127 participants), or no e-cigarettes (121 participants) for 12 weeks, with all receiving individual counseling. Self-reported smoking status was assessed at 12 and 24 weeks.

The researchers found that the point prevalence of abstinence was significantly greater for nicotine e-cigarettes plus counseling versus counseling alone at 12 weeks (21.9 versus 9.1 percent; risk difference [RD], 12.8; 95 percent confidence interval [CI], 4.0 to 21.6), but not 24 weeks (17.2 versus 9.9 percent; RD, 7.3; 95 percent CI, –1.2 to 15.7). For non-nicotine e-cigarettes plus counseling versus counseling alone, the point prevalence for abstinence was not significantly different at 12 weeks (17.3 versus 9.1 percent; RD, 8.2; 95 percent CI, –0.1 to 16.6) but was significantly greater at 24 weeks (20.5 versus 9.9 percent; RD, 10.6; 95 percent CI, 1.8 to 19.4). Adverse events were common for all groups (nicotine e-cigarette with counseling, 94 percent; non-nicotine e-cigarette with counseling, 93 percent; counseling only, 73 percent); cough (64 percent) and dry mouth (53 percent) were the most frequently reported.

"Trial interpretation is limited by early termination and inconsistent findings for nicotine and nonnicotine e-cigarettes, suggesting further research is needed," the authors write.

Two authors disclosed financial ties to Pfizer.

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Posted: November 2020

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